From Lab to Clinic: The Potential of Nanobubble Ozone Stored in Liposome with Pantothenic Acid (NOSLIP) in Treating Vaginal Infections with Long-lasting Effectiveness

Year 2024, , 181 - 186, 30.09.2024

Perihan Erkan Alkan , Talha Karabıyık

https://doi.org/10.56766/ntms.1492707

Abstract

Every year, 5-10 million women apply to various centers for sexually transmitted diseases due to infectious vaginitis (1). The three most notable causes of infectious vaginitis are bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV and VVC, which are endogenous genital infections, are the agents most responsible for the etiology of vaginal discharge (2). The most common symptoms of infectious vaginitis are vaginal discharge, itching, and a burning sensation. However, some cases are asymptomatic and are untreated (3).
Group B streptococci (Streptococcus agalactiae; GBS) are gram-positive encapsulated bacteria that can colonize the intestinal and vaginal flora in 10-30% of healthy adults (4). Streptococcus agalactiae causes serious infections such as meningitis, sepsis, skin and soft tissue infections, pneumonia, urinary tract infections, and postpartum endometritis in newborns, pregnant women and adults with underlying diseases (4-6).
Ozone is a highly reactive form of oxygen composed of three oxygen atoms. It is generated through the interaction of UV light and high-pressure diatomic oxygen. Ozone is widely acknowledged for its potent antibacterial properties due to its strong oxidative nature. Ozone therapy has garnered growing interest in recent years and is widely recognized for its beneficial impact on infection, reperfusion injury, cancer, and dental caries (7-8). At present, ozone therapy is an emerging approach in the clinical management of vaginitis. The medical ozone therapy device utilizes an ozone generator to produce a specific concentration of ozone, which is subsequently combined with filtered tap water to create ozonated water. Ozone and reactive chemicals exist in a liquid state and have a significant impact on vaginal sterilization (9).

Keywords

Nanobubble ozone,, Nanoliposome,, Vaginitis, Candida albicans, Antibacterial agent, Antifungal agent

References

• Otuonye NM, Odunukwe NN, Idıgbe EO. Aetiological agents of vaginitis in Nigerian women. Br. J. Biomed. Sci. 2004; 61(4): 175-78.
• Fleury FJ. Adult vaginitis. Clin Obstet Gynecol. 1981; 24: 407-38.
• Coco AS, Vanderbosch M. Women’s health infectious vaginitis, an accurate diagnosis is essential and attainable. Post Grad Med. 2000; 1: 1-9.
• Hays CLouis M, Plainvert CDmytruk NTouak GTrieu-Cuot PPoyart C, Tazi A. Changing Epidemiology of Group B Streptococcus Susceptibility to Fluoroquinolones and Aminoglycosides in France. Antimicrob Agents Chemother. 2016; 60(12):7424-30.
• Wang YH, Chen HM, Yang YH. Clinical and microbiological characteristics of recurrent group B streptococcal infection among non-pregnant adults. Int J Infect Dis. 2014; 26:140-45.
• Aracil B, Minambres M, Oteo J, De La Rosa M, GomezGarces JL, Alos AJ. Susceptibility of strains of Streptococcus agalactiae to macrolides and lincosamides, phenotype patterns, and resistance genes. Clin Microbiol Infect. 2002; 8(11):745-48.
• Zhang QQ, Zhang L, Liu Y, Wang Y, Chen R, Huang ZY, Lyu T, Liao QP. Effect of ozonated water on normal vaginal microecology and Lactobacillus. Chin Med J. 2019; 132:1125-27.
• Almaz ME, Sonmez IS. Ozone therapy in the management and prevention of caries. J Formos Med Assoc. 2015; 114:3-11.
• Vaginal insufflation of an ozone-oxygen mixture (VIO3O2M) ISCO3 MET/00/13. 2016;1(www.isco3.org):8. 47. ISCO3.
• Clinical and Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. CLSI standard M07. 11th ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2018.
• Clinical and Laboratory Standards Institute (CLSI). Reference method for broth dilution antifungal susceptibility testing of yeasts: approved standard-third edition. CLSI document (M27-A3), 2008. CLSI, Wayne, PA.
• Sabancı AU, Erkan Alkan P, Mujde C, Polat HU, Ornek Erguzeloglu C, Bisgin A, Ozakın C, Temel SG. Nanobubble Ozone Stored in Hyaluronic Acid Decorated Liposomes: Antibacterial, Anti-SARS-CoV-2 Effect and Biocompatibility Tests. Int J Nanomed. 2022; 17:351-79.
• Muzny C and Sobel J. The role of antimicrobial resistance in refractory and recurrent bacterial vaginosis and current recommendations for treatment. Antibiotics. 2022; 11(4):500.
• Zhang W. Vaginal microecological imbalance and expression of serum inflammatory factors in pregnant women with group b streptococcus infection and pregnancy outcome. Cell Mol Biol. 2023; 69(15):48-153.
• Wang L, He L, Chen J, Wei S, Xu H, Luo M. Hpv and vaginal microecological disorders in infertile women: a cross-sectional study in the chinese population. Virol J. 2022; 19(1).
• Kim H. Analyses of the chemical composition of plasma-activated water and its potential applications for vaginal health. Biomedicines. 2023; 11(12):3121.
• Wang Q. Efficacy and mechanism of baicao fuyanqing suppository on mixed vaginitis based on 16s rrna and metabolomics. Frontiers in Cell Infect Microbiol. 2023; 13.
• Khazaeian S, Navidian A, Navabirigi S, Araban M, Mojab F, Khazaeian S. Comparing the effect of sucrose gel and metronidazole gel in treatment of clinical symptoms of bacterial vaginosis: a randomized controlled trial. Trials. 2018; 19(1).
• Wu X, Liu J, Pan Y, Liu H, Zhang M, Shu J. Characteristics of the vaginal microbiomes in prepubertal girls with and without vulvovaginitis. Eur J Clin Microbiol Infect Dis. 2021; 40(6):1253-61.
• Kim H. Analyses of the chemical composition of plasma-activated water and its potential applications for vaginal health. Biomedicines. 2023; 11(12):3121.
• Wu Y. Cotton fibers with a lactic acid‐like surface for re‐establishment of protective lactobacillus microbiota by selectively inhibiting vaginal pathogens. Adv Healthc Mat. 2023; 13(7).
• Zhang, H., Jin, S., Ji, A., & Shi, S. (2022). Correlation between vaginal microecological status and prognosis of cin patients with high-risk hpv infection. Biomed Research International, 2022; 2022:3620232.
• Coste I, Judlin P, Lepargneur J. Safety and efficacy of an intravaginal prebiotic gel in the prevention of recurrent bacterial vaginosis: a randomized double-blind study. Obstet Gynecol Int. 2012; 2012:147867.
• Chitulea P. The role of intravaginal prebiotics in controlling the evolution of uncomplicated bacterial and fungal vaginal infections. Farmacia. 2022; 70(3):545-49.